WHO Expert Committee on Leprosy

Abstract

Considerable progress has been made in the fight against leprosy during the past 10-15 years, following the introduction of multidrug therapy (MDT) regimens and the establishment of the goal of eliminating leprosy as a public health problem by the year 2000. Current estimates indicate that there are about 1.15 million cases of leprosy in the world, compared with 10-12 million cases in the mid-1980s. This report presents the conclusions of a WHO Expert Committee convened to review the global leprosy situation and the technology available for eliminating the disease, to identify the remaining obstacles to reaching the goal of eliminating leprosy as a public health problem, and to make appropriate recommendations for the future on technical and operational matters. The current status of leprosy elimination is discussed, and the various antileprosy drugs are reviewed, including the most recently available drugs. On the basis of field trials and clinical studies, the Committee concludes that a single dose of a combination of rifampicin, ofloxacin and minocycline is an acceptable and cost-effective alternative regimen for the treatment of single-lesion paucibacillary leprosy, and that the duration of the current MDT regimen for multibacillary leprosy could possibly be shortened to 12 months. The Committee points out the need for improved management of reactions and neuritis and prevention of leprosy-related disabilities and impairments, and recommends that antileprosy activities should become an integral part of general health services and should involve communities to the fullest extent possible.